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One hundred and twenty-seven children who presented with features of acute hepatitis during the period February 1995 to January 1996 were studied. Specific aetiologic agents were identified in 89 per cent. Of these, 67.7 per cent were due to a single virus, whereas 21.3 per cent were due to two or more hepatitis viruses. Hepatitis A virus (HAV) was the sole infecting agent in 38.6 per cent of cases, hepatitis B virus (HBV) in 13.4 per cent of cases, and hepatitis E virus (HEV) in 15.7 per cent of cases. Mixed infections were due to HAV and HBV co-infection (7.1 per cent), HAV and HEV (13.4 per cent), and the combination of HAV, HBV, and HEV (0.8 per cent). In 11 per cent, none of the markers (HAV to HEV) were identified. Acute sporadic hepatitis in children can occur due to a single hepatitis virus type or, at times, due to co-infection with a combination of two enterally transmitted viruses or enteral and parenterally transmitted viruses. Improving personal hygiene and active immunization are essential in the prevention of these viral illnesses. This study was done in a referral centre and hence we report a higher morbidity (13.4 per cent) and mortality (12.6 per cent) rate in all groups of infection. Hence, apart from the viruses, factors such as the age of the child, nutritional status, and treatment taken prior to hospitalization should be taken into consideration to predict the prognosis in a given child.

Clinical and viral marker pattern of acute sporadic hepatitis in children in Madras, South India